Why are so few Physician Assistants (PAs) entering the telemedicine space, and how can they overcome the barriers to start their own practices?

In this episode of Telemedicine Talks, Phoebe Gutierrez and Dr. Leo Damasco are joined by a panel of innovative providers: Ashlyn Smith, Christina Davis, Savannah Elgins, and Katie Wakeland. Together, they share their journeys from traditional clinic settings to telemedicine entrepreneurship, highlighting the frustrations with the broken healthcare system, insurance challenges, and the shift to cash-pay models.

The group discusses state-specific regulations like corporate practice of medicine (CPOM), the differences between supervising and collaborating physicians, and business structures such as PLLCs, PC-MSOs, and LLCs. They emphasize the importance of finding your "why," building community through groups like the Independent PA Collective (IPAC), and embracing an entrepreneurial mindset—including learning from mistakes, pivoting, and overcoming imposter syndrome. From addressing care gaps in rural areas to leveraging telemedicine for flexible, patient-centered care, this episode offers practical insights for PAs (and NPs) looking to disrupt healthcare and scale their impact nationwide.

Three Actionable Takeaways:

Know Your State Laws and Build the Right Structure: PAs face unique regulatory hurdles like CPOM and supervision requirements—research your state's rules on collaboration vs. supervision, and consider structures like PLLCs or PC-MSOs to enable ownership while partnering with physicians.
Find Your "Why" and Join a Supportive Community: Clarify your mission to stay motivated through challenges; seek out groups like the Independent PA Collective (IPAC) for mentorship, shared knowledge, and encouragement from peers who've navigated similar paths.
Embrace Mistakes and Prioritize Balance: Shift from a risk-averse clinical mindset to an entrepreneurial one—expect pivots, learn from failures, and remember to set boundaries, as you're irreplaceable only to your loved ones, not your job.

About the Show:

Telemedicine Talks explores the evolving world of digital health, helping physicians navigate new opportunities, regulatory challenges, and career transitions in telemedicine.

About the Guests:

Ashlyn Smith is an endocrine PA based in Arizona with 15 years of experience, passionate about whole-person care in endocrinology. She's certified in lifestyle medicine and advanced diabetes management, and runs her own telemedicine practice focused on bridging care gaps.

Christina Davis is a PA in Florida's Panhandle specializing in developmental behavioral pediatrics with a functional medicine approach. She operates a hybrid telemedicine practice to serve underserved families nationwide.

Savannah Elgins is a PA with over 20 years living with type 1 diabetes and an endocrinology background. She's co-founder of a telemedicine practice dedicated to specialized type 1 diabetes care.

Katie Wakeland is a nurse practitioner with an endocrinology focus and type 1 diabetes experience. She partners with Savannah Elgins to provide patient-centered, tech-savvy care outside traditional systems.

About the Hosts:

Dr. Leo Damasco – Pediatrician and emergency medicine doctor turned telemedicine advocate, helping physicians transition to digital health.
Phoebe Gutierrez – Former state regulator turned telehealth executive, specializing in compliance and sustainable virtual care models.
Connect with Phoebe Gutierrez:
https://www.linkedIn.com/in/pkgutierrez/
phoebe@telemedicinetalks.com (mailto:phoebe@telemedicinetalks.com)

The information provided in Telemedicine Talks is for educational and informational purposes only and should not be construed as medical, legal, or financial advice. While we discuss best practices, industry trends, and real-world experiences, every situation is unique. Listeners should consult with qualified professionals before making decisions related to telemedicine practice, compliance, contracts, or business operations. The views expressed by the hosts and guests are their own and do not necessarily reflect those of any organizations they may be affiliated with.

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